NPI Code Details Logo

NPI 1912891664

NPI 1912891664 : GRACE ELIZABETH HAMMER : LA PORTE, IN

=====================================================
General NPI Number Information
=====================================================
    NPI Number           |    1912891664
-----------------------------------------------------
    Entity Type          |    Individual 
-----------------------------------------------------
    Provider Name        |    GRACE ELIZABETH HAMMER
-----------------------------------------------------
    Gender               |    Female 
-----------------------------------------------------

=====================================================
Dates
=====================================================
    Enumeration Date     |    06/06/2025
-----------------------------------------------------
    Last Update Date     |    10/16/2025
-----------------------------------------------------

=====================================================
Provider Practice Location Address
=====================================================
    Address Line         |    900 I ST 
-----------------------------------------------------
    City                 |    LA PORTE
-----------------------------------------------------
    State                |    IN
-----------------------------------------------------
    Zip                  |    46350-5533
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    219-324-1700
-----------------------------------------------------
    Fax                  |    219-324-1602
-----------------------------------------------------

=====================================================
Provider Business Mailing Address
=====================================================
    Address Line         |    3245 HEALTH DR STE 100 
-----------------------------------------------------
    City                 |    GRANGER
-----------------------------------------------------
    State                |    IN
-----------------------------------------------------
    Zip                  |    46530-1380
-----------------------------------------------------
    Country              |    US
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------
    Fax                  |    
-----------------------------------------------------

=====================================================
Authorized Official
=====================================================
    Title or Position    |    
-----------------------------------------------------
    Name                 |        
-----------------------------------------------------
    Credential           |    
-----------------------------------------------------
    Telephone            |    
-----------------------------------------------------

=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
    Taxonomy Code        |    363LF0000X
-----------------------------------------------------
    Taxonomy Name        |    Family Nurse Practitioner
-----------------------------------------------------
    License Number       |    71016873A
-----------------------------------------------------
    License Number State |    IN
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
    Taxonomy Code        |    163WN0002X
-----------------------------------------------------
    Taxonomy Name        |    Neonatal Intensive Care Registered Nurse
-----------------------------------------------------
    License Number       |    28264562A
-----------------------------------------------------
    License Number State |    IN
-----------------------------------------------------



                        

Copyright © 2007-2025 Data Labs Health. All rights reserved.